{"paper_id":"26c00456-994d-4842-bb37-14bca8a7333b","body_text":"International Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \nRetrospective\n \nDescriptive\n \nS\ntudy\n \nof\n \nAtypical\n \n&\n \nExtrapelvic\n \nmanifestations\n \nof\n \nEndometriosis:\n \nClinical\n \nPerspectives\n \n \nDr.\n \nSunil\n \nK.\n \nJuneja\n1\n,\n \nDr.\n \nMuskan\n \nChaudhary\n2\n,\n \nDr.\n \nSatpal\n \nSingh\n \nVirk\n3\n,\n \n \nDr.\n \nPooja\n \nTandon\n4\n,\n \nDr.\n \nHarsimran\n \nSingh\n5\n \n \n1\nDepartment\n \nof\n \nObstetrics\n \n&\n \nGynaecology,\n \nDayanand\n \nMedical\n \nCollege\n \n&\n \nHospital,\n \nLudhiana\n \n \n2\nDepartment\n \nof\n \nObstetrics\n \n&\n \nGynaecology,\n \nDayanand\n \nMedical\n \nCollege\n \n&\n \nHospital,\n \nLudhiana\n \nCorresponding\n \nAuthor\n \nEmail:\n \nmuskanchaudhary96[at]gmail.com\n \n \n3\nDepartment\n \nof\n \nGastrosurgery,\n \nDayanand\n \nMedical\n \nCollege\n \n&\n \nHospital,\n \nLudhiana\n \n \n4\nDepartment\n \nof\n \nObstetrics\n \n&\n \nGynaecology,\n \nDayanand\n \nMedical\n \nCollege\n \n&\n \nHospital,\n \nLudhiana\n \n \n5\nDepartment\n \nof\n \nSurgery,\n \nRG\n \nStone,\n \nUrology\n \n&\n \nLaparoscopic\n \nSurgery,\n \nLudhiana\n \n \n \nAbstract\n:\n \nBackground\n:\n \nEndometriosis\n \nis\n \ncommonly\n \nfound\n \nin\n \napproximately\n \n10%\n \nto\n \n15%\n \nof\n \nwomen\n \nbetween\n \n25\n \nto\n \n44\n \nyears\n \nof\n \nage,\n \nand\n \nin\n \ninfertile\n \nwomen\n \nincidence\n \nof\n \nendometriosis\n \nis\n \nalmost\n \n25%\n \nto\n \n40%\n \n[1].\n \nMethods\n:\n \nThis\n \nwas\n \na\n \nretrospective\n \ndescriptive\n \nstudy\n \nconducted\n \nat\n \na\n \ntertiary\n \ncare\n \nteaching\n \nhospital\n \nfrom\n \nJanuary\n \n2023\n \nto\n \nJanuary\n \n2025.\n \nInclusion\n \ncriteria\n \nincluded\n \nwomen\n \nwith\n \nhistopathologically\n \nconfirmed\n \nendometriosis\n \nat\n \nextrapelvic\n \nor\n \natypical\n \nsites.\n \nPatients\n \nwit\nh\n \nincomplete\n \nrecords\n \nwere\n \nexcluded.\n \nData\n \nregarding\n \ndemographics,\n \nclinical\n \npresentation,\n \nimaging\n \nfindings,\n \nsurgical\n \nmanagement,\n \nand\n \nhistopathology\n \nwere\n \ncollected\n \nand\n \nanalysed\n \ndescriptively.\n \nResults\n:\n \nThis\n \nstudy\n \nfound\n \nthat\n \nendometriosis\n \ncan\n \npresent\n \nwith\n \na\n \nwide\n \nrange\n \nof\n \nsymptoms\n \nbeyond\n \nthe\n \ntypical\n \npelvic\n \npain\n \nand\n \ninfertility.\n \nA\n \ntotal\n \nof\n \n48\n \nwomen\n \nwith\n \natypical\n \nand\n \nextra\n-\npelvic\n \nmanifestations\n \nof\n \nendometriosis\n \nwere\n \nincluded\n \nduring\n \nthe\n \nstudy\n \nperiod.\n \nThe\n \npr\nesentations\n \nincluded\n \nepisiotomy\n \nscar\n \nendometriosis\n \n(n=6),\n \ncutaneous\n \nendometriosis\n \n(n=8),\n \nintestinal\n \nendometriosis\n \n(n=16),\n \ncesarean\n \nscar\n \nendometriosis\n \n(n=16),\n \none\n \ncase\n \nof\n \numbilical\n \nendometriosis\n \n&\n \none\n \ncase\n \nof\n \nuterocutaneous\n \nfistula.\n \nConclusions\n:\n \nThis\n \npaper\n \nhas\n \nhighlighted\n \nthe\n \nimportance\n \nof\n \nrecognising\n \nand\n \nunderstanding\n \natypical\n \nmanifestations\n \nof\n \nendometriosis.\n \nBy\n \nshedding\n \nlight\n \non\n \nthe\n \nvarious\n \nways\n \nin\n \nwhich\n \nthis\n \ncondition\n \ncan\n \npresent\n \noutside\n \nof\n \nthe\n \npelvis,\n \nhealthcare\n \nproviders\n \ncan\n \nimprove\n \ndiagnosi\ns\n \nand\n \nmanagement\n \nstrategies\n \nfor\n \npatients\n \nwith\n \nendometriosis.\n \nFurther\n \nresearch\n \nis\n \nneeded\n \nto\n \nbetter\n \nunderstand\n \nthe\n \nunderlying\n \nmechanisms\n \ndriving\n \nthese\n \nextra\n-\npelvic\n \nmanifestations\n \nand\n \nto\n \ndevelop\n \nmore\n \neffective\n \ntreatment\n \noptions.\n \nOverall,\n \nincreasing\n \nawareness\n \nand\n \nknowledge\n \nof\n \nthese\n \nmanifestations\n \nis\n \ncrucial\n \nin\n \nproviding\n \ncomprehensive\n \ncare\n \nfor\n \nindividuals\n \nliving\n \nwith\n \nendometriosis.\n \n \nKeywords:\n \nendometriosis,\n \nextra‐pelvic\n \nendometriosis\n,\n \ncutaneous\n \nendometriosis,\n \nscar\n \nendometriosis.\n \n \n \n1.\n \nIntroduction\n \n \nEndometriosis\n \nis\n \ncommonly\n \nfound\n \nin\n \napproximately\n \n10%\n \nto\n \n15%\n \nof\n \nwomen\n \nbetween\n \n25\n \nand\n \n44\n \nyears\n \nof\n \nage,\n \nand\n \nin\n \ninfertile\n \nwomen\n \nincidence\n \nof\n \nendometriosis\n \nis\n \nalmost\n \n25%\n \nto\n \n40%\n \n[1].\n \n \n \nThe\n \ncommon\n \nsites\n \nof\n \ninvolvement\n \nin\n \ndecreasing\n \norder\n \nof\n \nfrequency\n \nare\n \nthe\n \novaries,\n \npelvic\n \nperitoneum,\n \ndeep\n \npelvic\n \nsub\n-\nperitoneal\n \nspaces,\n \nintestinal\n \nsystem,\n \nscar\n \nendometriosis,\n \nurinary\n \nsystem\n \nand\n \nthoracic\n \nendometriosis.\n \n \n \nThe\n \nmost\n \ncommon\n \nextra\n-\npelvic\n \nform\n \nof\n \nendometriosis\n \nis\n \ncutaneous\n \nendometriosis\n,\n \ninvolving\n \nscar\n \ntissues\n \noccurring\n \nafter\n \nobstetric\n \nor\n \ngynaecologic\n \nprocedures\n \nsuch\n \nas\n \nepisiotomy,\n \nhysterotomy,\n \ncaesarean\n \nsection,\n \nand\n \neven\n \nlaparoscopic\n \nsurgery.\n \nScar\n \nendometriosis\n \nvery\n \nrarely\n \ncan\n \nget\n \ncomplicated\n \nwith\n \nutero\n-\ncutaneous\n \nfistula.\n \nThere\n \nare\n \nreports\n \nof\n \nendometriosis\n \nin\n \nalmost\n \nall\n \nlocations,\n \nincluding\n \nkidneys,\n \nlungs,\n \nand\n \ncentral\n \nnervous\n \nsystem\n \n[2]\n \n \n1)\n \nEpisiotomy\n \nScar\n \nEndometriosis\n \nEndometriosis\n \nat\n \nthe\n \nscar\n \nsite\n \ncan\n \nbe\n \nfound\n \nafter\n \nperineal\n \nepisiotomy,\n \ncesarean,\n \nhysterectomy,\n \nlaparoscopic\n \ntrocar\n \ntract,\n \nor\n \namniocentesis.[3]\n   \nEpisiotomy\n \nscar\n \nendometriosis\n \nis\n \na\n \nrelatively\n \nuncommon\n \ncondition\n \nand\n \nis\n \nusually\n \ndiagnosed\n \nlate\n \nbecause\n \nof\n \nunawareness\n \nabout\n \nthe\n \ncondition\n \namong\n \ngeneral\n \nsurgeons,\n \nresulting\n \nin\n \nprolonged\n \nsuffering\n \nto\n \nthe\n \npatient\n \nand\n \nincreased\n \nmorbidity.\n \n \nCase\n \nselection:\n \n6\n \npatients\n \nwere\n \nincluded\n \nwho\n \npresented\n \nto\n \nthe\n \nGynaecology\n \noutpatient\n \ndepartment\n \nwith\n \nhistory\n \nof\n \nvaginal\n \ndelivery\n \nwith\n \nepisiotomy\n \n(mediolateral\n \nor\n \nmedian)\n \nwith\n \nthe\n \npresence\n \nof\n \na\n \nperineal/\n \nepisiotomy\n \nscar\n \nlesion.\n \n \nSymptoms\n:\n \nComplaints\n \nof\n \npain\n \nand\n \nswelling\n \nin\n \nthe\n \nperineal\n \nregion\n \nfor\n \nyears,\n \nboth\n \nof\n \nwhich\n \nincreased\n \nduring\n \nmenstruation.\n  \nFour\n \nof\n \nthem\n \nhad\n \ncomplaints\n \nof\n \ndyspareunia.\n \nTheir\n \nmenstrual\n \ncycles\n \nwere\n \nregular\n \nwith\n \naverage\n \nflow,\n \nnot\n \nassociated\n \nwith\n \ndysmenorrhea.\n \n \n \nTable\n \n1:\n \nSummary\n \nof\n \nClinical\n \nSymptoms\n \nin\n \nPatients\n \nSymptoms\n \nTotal\n \nPatients\n \n(n=6)\n \n1.\n \nPain\n \nin\n \nPerineal\n \nArea\n \n6\n \n2.\n \nSwelling\n \nin\n \nPerineal\n \nArea\n \n6\n \n3.\n \nDyspareunia\n \n4\n \n4.\n \nDysmenorrhea\n \n0\n \n \nAll\n \n6\n \npatients\n \nreported\n \npain\n \nand\n \nswelling\n \nin\n \nthe\n \nperineal\n \narea.\n \nAmong\n \nthem,\n \n4\n \nexperienced\n \ndyspareunia\n \nin\n \nconjunction\n \nwith\n \nthese\n \nsymptoms,\n \nwhile\n \nnone\n \nreported\n \ndysmenorrhea.\n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n172 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \nOn\n \nvaginal\n \nexamination\n:\n \nFive\n \npatients\n \nhad\n \na\n \nwell\n-\ndefined\n \nnodular\n \nmass\n \nfelt\n \nat\n \nthe\n \nsite\n \nof\n \nepisiotomy,\n \nfirm\n \nto\n \nhard\n \nin\n \nconsistency\n \nand\n \ntender.\n \nSame\n \nnodular\n \nmass\n \nwas\n \nfelt\n \non\n \nper\n \nrectal\n \nexamination.\n \nRectal\n \nmucosa\n \nwas\n \nfree\n \nof\n \nany\n \nmass.\n \n \n \nFigure\n \n1:\n \nPreoperative\n \nimage\n \nshowing\n \nthe\n \npuckered\n \nscar.\n \n \nBased\n \non\n \ncharacteristic\n \nhistory\n \nand\n \nexamination\n \nfindings,\n \na\n \nprobable\n \ndiagnosis\n \nof\n \ndeep\n \nepisiotomy\n \nscar\n \nendometriosis\n \nwas\n \nconsidered.\n \n \nInvestigations\n:\n \nA\n \nmagnetic\n \nresonance\n \nimaging\n \n(MRI)\n \nscan\n \nof\n \nthe\n \npelvis\n \nwas\n \ndone\n \nto\n \nrule\n \nout\n \nan\n \nextension\n \nto\n \nthe\n \nanal\n \nsphincter.\n \nMRI\n \nwas\n \nsuggestive\n \nof\n \na\n \nlesion\n \nat\n \nthe\n \nright\n \nmediolateral\n \nsite\n \nin\n \nall\n \nsix\n \ncases,\n \nand\n \nthe\n \nlikely\n \ndiagnosis\n \nwas\n \nscar\n \nendometriosis.\n \nFNAC\n \nwas\n \ndone\n \nin\n \nall\n \ncases\n \nto\n \nconfirm\n \nthe\n \ndiagnosis.\n \n \nManagement:\n \nIn\n \nall\n \ncases,\n \nepisiotomy\n \nscar\n \nendometriosis\n \nexcision\n \nwas\n \ndone\n \nunder\n \ncombined\n \nspinal\n-\nepidural\n \nanaesthesia.\n \nThe\n \nwhole\n \nendometriotic\n \ntissue,\n \nwith\n \na\n \nmargin\n \nof\n \n1\n \ncm\n \nof\n \nhealthy\n \ntissue,\n \nwas\n \nexcised.\n \n \nOn\n \nHPE,\n \nthe\n \npresence\n \nof\n \nendometrial\n \nglands\n \nand\n \nstroma\n \nconfirmed\n \nthe\n \ndiagnosis\n \nof\n \nepisiotomy\n \nscar\n \nendometriosis.\n \n \n \n \n \n \n \n \n \n \nFigure\n \n2:\n \nExcised\n \nspecimen\n \nand\n \nits\n \ncut\n \nsection.\n \n \n2)\n \nCutaneous\n \nEndometriosis:\n \n \nCutaneous\n \nendometriosis\n \nis\n \na\n \nrare\n \ncondition\n \nthat\n \nusually\n \naffects\n \nthe\n \nabdominal\n \nwall\n \nin\n \nwomen\n \nwith\n \na\n \nhistory\n \nof\n \nabdominal\n \nsurgery.\n \nClinical\n \nfeatures\n \ninclude\n \nthe\n \npresence\n \nof\n \nan\n \nabdominal\n \nmass\n \nand\n \npain\n \nassociated\n \nwith\n \nmenstruation.\n \nThe\n \ntreatment\n \nis\n \nusually\n \nsu\nrgery.\n \n \n \nCase\n \nselection\n:\n  \nA\n \ntotal\n \nof\n \n10\n \npossible\n \ncases\n \nwere\n \ninitially\n \nobtained,\n \nof\n \nwhich\n \n2\n \ncases\n \nwere\n \nexcluded\n \ndue\n \nto\n \ntheir\n \nclinical\n \nhistories\n \nwere\n \nincomplete.\n \n \n \nOut\n \nof\n \n8\n \npatients,\n \nthere\n \nwas\n \nno\n \nsurgical\n \nhistory\n \nin\n \n2\n \nwomen,\n \nbeing\n \ncases\n \nof\n \nprimary\n \ncutaneous\n \nendometriosis.\n \nIn\n \nremaining\n \n6,\n \nthere\n \nwas\n \nat\n \nleast\n \none\n \nprevious\n \nsurgery.\n \nCaesarean\n \nsection\n \nwas\n \nthe\n \nmain\n \nsurgical\n \nhistory\n \n(n\n \n=\n \n4),\n \nfollowed\n \nby\n \nlaparotomy\n \n(n\n \n=\n \n1)\n \nand\n \nappendectomy\n \n(n\n \n=\n \n1).\n \n \n \nThe\n \nlesions\n \nwere\n \nsingle\n \nin\n \n100%\n \nof\n \ncases.\n \nThey\n \nwere\n \nlocated\n \nover\n \nthe\n \nsurgical\n \nscar\n \nin\n \n6\n \nof\n \n8\n \nwomen\n \nand\n \numbilical\n \nregion\n \nin\n \ntwo\n \ncases.\n \n \n \nSymptoms\n:\n \nThe\n \nmain\n \nsymptom\n \nwas\n \nthe\n \npresence\n \nof\n \nan\n \nabdominal\n \nmass.\n \nPain\n \nwas\n \npresent\n \nin\n \n7\n \nof\n \n8\n \nwomen,\n \nbeing\n \nassociated\n \nwith\n \nmenstruation.\n \nThe\n \nmean\n \ntime\n \nperiod\n \nbetween\n \nthe\n \nlast\n \nsurgical\n \nintervention\n \nand\n \nthe\n \nconsultation\n \nwas\n \n6.5\n \nyears.\n \n \n \nInvestigations\n:\n \nAs\n \nimaging\n \ntests,\n \nultrasound\n \nwas\n \nused\n \nin\n \nall\n \nwomen,\n \nfollowed\n \nby\n \na\n \nMRI\n \n(magnetic\n \nresonance\n \nimaging)\n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n173 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \nscan\n \nin\n \n6\n \npatients.\n \nThe\n \nmain\n \ndiagnostic\n \ntool\n \nused\n \nwas\n \nfine\n \nneedle\n \naspiration,\n \nwhich\n \nwas\n \nused\n \nin\n \n6\n \npatients.\n \n \n \nManagement:\n \nThe\n \ntreatment\n \nwas\n \nsurgical\n \nall\n \ncases.\n \nConservative\n \ntreatment\n \nwas\n \ndecided\n \nin\n \nthe\n \nremaining\n \ncases\n \ndue\n \nto\n \nthe\n \nrefusal\n \nof\n \nsurgery\n \nby\n \nthe\n \npatient\n \nor\n \nthe\n \nnearness\n \nto\n \nthe\n \nmenopause.\n \nThe\n \nusual\n \nsurgical\n \ntechnique\n \nwas\n \nexcision\n \nof\n \nthe\n \nendometrioma,\n \nwith\n \nsubsequent\n \nrepair\n \nof\n \nthe\n \nfascial\n \ndefect\n[4]\n.\n \nA\n \nprosthetic\n \nmesh\n \nwas\n \nused\n \nto\n \nrepair\n \nthe\n \ndefect\n \nin\n \n8\n \ncases.\n \nThe\n \ntreatment\n \nwas\n \nomphalectomy\n \nen\n \nbloc\n \nin\n \n3\n \nof\n \nthe\n \ncases.\n \n \n \n \nFigure\n \n3:\n \nCutaneous\n \nEndometriosis\n \n \nHistologically\n,\n \nthe\n \nfinal\n \ndiagnosis\n \nwas\n \ndetermined\n \nby\n \nsubcutaneous\n \npresence\n \nof\n \nstroma\n \nand\n \ntissue\n \nendometrial\n \nglandular\n \nwith\n \nfrequent\n \nsigns\n \nof\n \nintraglandular\n \nand\n \ninterstitial\n \nbleeding\n \nand\n \nwith\n \ncharacteristic\n \nsigns\n \nof\n \nhormonal\n \ntransformation\n \ninto\n \nproliferative\n \nor\n \nsecretor\ny.\n \n \n \n3)\n \nIntestinal\n \nEndometriosis\n \nIntestinal\n \nendometriosis\n \nis\n \na\n \nrare\n \nform\n \nof\n \ndeep\n \ninfiltrating\n \nendometriosis,\n \noften\n \nmisdiagnosed\n \ndue\n \nto\n \nits\n \nnonspecific\n \ngastrointestinal\n \nsymptoms.\n \nBowel\n \ninvolvement\n \naccounts\n \nfor\n \n5%\n \nto\n \n12%\n \nof\n \nthe\n \nwomen\n \npresenting\n \nwith\n \nthe\n \ndisease,\n \nwith\n \nthe\n \nrectum\n \nand\n \nsigmoid\n \ninvolved\n \nin\n \nup\n \nto\n \n90%\n \nof\n \nall\n \nintestinal\n \nlesions.\n \n[5]\n \n \nThis\n \nstudy\n \nevaluates\n \nthe\n \nclinical\n \npresentation,\n \ndiagnostic\n \nmodalities,\n \nand\n \nsurgical\n \noutcomes\n \nin\n \n16\n \npatients\n \nwith\n \nhistologically\n \nconfirmed\n \nintestinal\n \nendometriosis.\n \n \nCase\n \nselection\n:\n \nA\n \nretrospective\n \nanalysis\n \nwas\n \nconducted\n \non\n \n16\n \nwomen\n \ndiagnosed\n \nwith\n \nintestinal\n \nendometriosis\n \nbased\n \non\n \nsurgical\n \nfindings\n \nand\n \nhistopathological\n \nconfirmation.\n \nData\n \non\n \npatient\n \ndemographics,\n \nsymptoms,\n \nimaging,\n \nintraoperative\n \nfindings,\n \nand\n \npostoperative\n \noutcomes\n \nw\nere\n \ncollected\n \nand\n \nanalysed.\n \n \nSymptoms:\n \nThe\n \nrectosigmoid\n \ncolon\n \nwas\n \nthe\n \nmost\n \ncommonly\n \naffected\n \nsite\n \n(75%),\n \nfollowed\n \nby\n \nthe\n \nileum\n \n(12.5%)\n \nand\n \ncecum\n \n(12.5%).\n \n \n \n \n \nTable\n \n3:\n \nSummary\n \nof\n \nClinical\n \nSymptoms\n \nin\n \nPatients\n \nSymptoms\n \nTotal Patients (n=16)\n \n1.\n \nCyclical Pelvic Pain\n \nAll 16\n \n2.\n \nConstipation\n \n12\n \n3.\n \n \nDyschezia\n \n11\n \n4.\n \nRectal Bleeding\n \n4\n \n \nInvestigations\n:\n \nPelvic\n \nMRI\n \ndemonstrated\n \ndeep\n \ninfiltrating\n \nlesions\n \nin\n \n75%\n \nof\n \ncases,\n \nwhile\n \ncolonoscopy\n \nshowed\n \nlimited\n \ndiagnostic\n \nutility.\n \n \nManagement:\n \nAll\n \npatients\n \nunderwent\n \nsurgical\n \nmanagement:\n \nsegmental\n \nbowel\n \nresection\n \n(56.2%),\n \ndisc\n \nexcision\n \nor\n \nshaving\n \n(43.7%).\n \nHistology\n \nconfirmed\n \nendometrial\n \nglands\n \nand\n \nstroma\n \nin\n \nthe\n \nintestinal\n \nwall,\n \nwith\n \nmuscularis\n \npropria\n \ninvolvement\n \nin\n \n81.2%\n \nof\n \ncases.\n \nPostoperative\n \nsymptom\n \nrelief\n \nwas\n \nreported\n \nin\n \n87.5%\n \nof\n \npatients,\n \nwith\n \nminimal\n \ncomplications\n \nand\n \nno\n \nrecurrence\n \nin\n \n13\n \npatients\n \nfollowed\n \nup\n \nfor\n \n12\n \nmonths.\n \n \nIntestinal\n \nendometriosis\n \nposes\n \nsignificant\n \ndiagnostic\n \nchallenges\n \ndue\n \nto\n \nits\n \nmimicry\n \nof\n \nother\n \ngastrointestinal\n \ndisorders.\n \nPre\n \nor\n \nintraoperative\n \nsigmoidoscopy\n \nmay\n \nprove\n \nhelpful\n \nin\n \nruling\n \nout\n \nmalignancy.\n \nThe\n \ngold\n \nstandard\n \nfor\n \ndiagnosis\n \nis\n \nlaparoscopy\n \nand\n \nbiopsy,\n \nwhich\n \nallows\n \na\n \nfull\n \nassessment\n \nof\n \nthe\n \npelvis\n \nas\n \nwell\n \nas\n \nsurgical\n \nresection\n \nif\n \nrequired.\n \nSurgical\n \nmanagement,\n \ntailored\n \nto\n \nlesion\n \nextent,\n \nis\n \nassociated\n \nwith\n \nfavourable\n \noutcomes.\n \nMultidisciplinary\n \nevaluation\n \nis\n \nessential\n \nfor\n \noptimal\n \ncare.\n \n \n \n \n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n174 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \n4)\n \nUmblical\n \nEndometriosis\n \n \nExtrapelvic\n \nlocations\n \nare\n \nuncommon;\n \namong\n \nthese,\n \numbilical\n \nendometriosis,\n \nalso\n \ncalled\n \nVillar’s\n \nnodule,\n \naccounts\n \nfor\n \nless\n \nthan\n \n1%.\n \nIt\n \ncan\n \noccur\n \nspontaneously\n \n(primary)\n \nor\n \nafter\n \nprevious\n \nabdominal\n \nsurgeries\n \n(secondary).\n \nSurgical\n \nexcision\n \nremains\n \nthe\n \ngold\n \nstandard\n \ntreatment,\n \noffering\n \nboth\n \ndiagnosis\n \nand\n \ncure.\n \nRecurrence\n \nis\n \nrare\n \nwhen\n \ncomplete\n \nexcision\n \nis\n \nachieved.\n \nDue\n \nto\n \nthe\n \nrarity\n \nof\n \nthis\n \npresentation\n \nthat\n \ncase\n \nis\n \ndescribed\n \nseparately.\n \n \nCase\n \nselection:\n \nA\n \n44\n-\nyear\n-\nold\n \nP2L2\n \nwith\n \nprevious\n \nnormal\n \ndeliveries\n \nwoman\n \npresented\n \nto\n \nthe\n \ngynaecology\n \nclinic.\n \n \nSymptoms\n:\n \n \nPain\n \nand\n \nhemorrhagic\n \ndischarge\n \nfrom\n \nthe\n \numbilicus\n \nduring\n \nmenstruation,\n \nwhich\n \nwas\n \ncyclical\n \n&\n \nongoing\n \nfor\n \nfour\n \nmonths.\n \nThere\n \nwas\n \nno\n \nhistory\n \nof\n \nabdominal\n \nor\n \npelvic\n \nsurgery.\n \nShe\n \ndenied\n \ndysmenorrhea\n \nor\n \npelvic\n \npain.\n \n \nOn\n \nphysical\n \nexamination,\n \nthe\n \numbilicus\n \nshowed\n \na\n \nbluish,\n \ntender\n \nnodule\n \nmeasuring\n \napproximately\n \n1.5\n \ncm,\n \nwith\n \na\n \nsmall\n \namount\n \nof\n \nsero\n-\nhemorrhagic\n \ndischarge.\n \nThere\n \nwas\n \nno\n \nabdominal\n \nwall\n \ndefect\n \nor\n \nsigns\n \nof\n \nherniation.\n \n \nInvestigations\n:\n \nPelvic\n \nultrasound\n \nwas\n \nnormal,\n \nand\n \nan\n \nMRI\n \nof\n \nthe\n \nabdomen\n \nrevealed\n \na\n \nlocalised\n \nsoft\n \ntissue\n \nlesion\n \nconfined\n \nto\n \nthe\n \nsubcutaneous\n \numbilical\n \nregion,\n \nwith\n \nno\n \nintra\n-\nabdominal\n \nextension.\n \nDifferential\n \ndiagnoses\n \nincluded\n \numbilical\n \ngranuloma,\n \nneoplasm,\n \nor\n \nendometriosi\ns.\n \n \n \nFigure\n \n4:\n \nUmblical\n \nEndometriosis\n \n \nManagement:\n \nThe\n \npatient\n \nunderwent\n \nwide\n \nlocal\n \nexcision\n \nof\n \nthe\n \numbilical\n \nlesion\n \nunder\n \nlocal\n \nanaesthesia.\n \nHistopathological\n \nexamination\n \nrevealed\n \nendometrial\n \nglands\n \nsurrounded\n \nby\n \nstroma,\n \nconfirming\n \numbilical\n \nendometriosis.\n \n \n \n \nFigure\n \n5:\n \nHistopathology\n \nreport\n \nshowing\n \nbiopsy\n \nreport\n \nof\n \nexcised\n \numbilical\n \ncyst\n \n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n175 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \nPostoperatively,\n \nshe\n \nwas\n \nstarted\n \non\n \nGnRH\n \nanalogues\n \nfor\n \nhormonal\n \nsuppression.\n \nAt\n \n8\n-\nmonth\n \nfollow\n-\nup,\n \nshe\n \nwas\n \nasymptomatic\n \nwith\n \nno\n \nsigns\n \nof\n \n\\\nrecurrence.\n \n \n5)\n \nEndometriotic\n \nUterocutaneous\n \nFistula\n \n \nUtero\n-\ncutaneous\n \nfistula\n \n(UCF)\n \nis\n \nmostly\n \nseen\n \nafter\n \npost\n-\npartum\n \nor\n \npostoperative\n \ncomplications\n \n[6].\n \nAlthough\n \nuterovesical,\n \nutero\n-\ncolonic\n \nfistulae\n \nare\n \nnot\n \nuncommon,\n \nUtero\n-\ncutaneous\n \nfistula\n \nis\n \na\n \nrare\n \nclinical\n \nentity\n \nwith\n \nless\n \nthan\n \n15\n \ncases\n \nreported\n \nworldwide\n \nin\n \nthe\n \nlast\n \n20\n \nyears.\n \nFistula\n \nbetween\n \nthe\n \ngenital\n \ntract,\n \nbowel\n \nand\n \nskin\n \nresults\n \nmore\n \ncommonly\n \ndue\n \nto\n \nunderlying\n \nco\n-\nmorbidities\n \nlike\n \ntuberculosis,\n \nCrohn’s\n \ndisease,\n \nendometriosis\n \nto\n \ninadvertent\n \nretention\n \nof\n \nswabs\n \n(gossipyboma)\n \n[7].\n  \nD\nue\n \nto\n \nthe\n \nrarity\n \nof\n \nthis\n \npresentation\n \nthat\n \ncase\n \nis\n \ndescribed\n \nseparately.\n \n \nCase\n \nselection:\n \nA\n \n36\n-\nyear\n-\nold\n \nfemale\n \nP2L1\n \npresented\n \nin\n \nOctober\n \n2013\n \nwith\n \nthe\n \ncomplaint\n \nof\n \npain\n \nand\n \nswelling\n \non\n \nthe\n \ncesarean\n \nscar\n \non\n \nand\n \noff\n \nfor\n \n11\n \nyears.\n \nIn\n \naddition,\n \nshe\n \ndescribed\n \ncyclic\n \nbleeding\n \nalong\n \nwith\n \npus\n \nfrom\n \nthis\n \ncesarean\n \nscar\n \nfor\n \n11\n \nyears.\n \nShe\n \npreviously\n \nhad\n \non\ne\n \nspontaneous\n \nvaginal\n \ndelivery\n \n14\n \nyears\n \nago\n \nand\n \na\n \ncesarean\n \nsection\n \n12\n \nyears\n \nback\n \nin\n \nview\n \nof\n \nnon\n-\nprogression\n \nof\n \nlabour.\n \nShe\n \ndescribed\n \npain\n \nover\n \nthe\n \ncesarean\n \nscar\n \nat\n \nthe\n \nlower\n \nend\n \nthat\n \nincreased\n \nduring\n \nthe\n \nmenstruation\n \nand\n \nthen\n \nnoticed\n \na\n \nswelling\n \nover\n \nthe\n \nce\nsarean\n \nscar\n \nat\n \nthe\n \nlower\n \nend.\n \nShe\n \nnoticed\n \nmild\n \nbleeding\n \nfrom\n \nthe\n \nscar\n \nwithin\n \nthe\n \n1\nst\n \ndays\n \nof\n \nher\n \nmenstruation\n \nfollowed\n \nby\n \npus.\n \n \n \nExamination\n \nrevealed\n \na\n \nwell\n-\nhealed\n \ncesarean\n \nscar,\n \na\n \nmoderately\n \npigmented\n \narea,\n \nand\n \ntenderness\n \nat\n \nthe\n \nlower\n \nend\n \nof\n \nthe\n \nvertical\n \ninfra\n \numbilical\n \nscar\n \non\n \npalpation.\n \n \n \nInvestigations\n:\n \nUltrasound\n \n[\nFigure\n \n1\n]\n \nshowed\n \nthat\n \nan\n \nill\n-\ndefined\n \nhypoechoic\n \nlobulated\n \nlesion\n \n3.3\n \ncm\n \n×\n \n2.7\n \ncm\n \nis\n \nseen\n \nin\n \nrelation\n \nto\n \nthe\n \nsuperior\n \nsurface\n \nof\n \nthe\n \nuterus\n \nto\n \nthe\n \nskin\n \nsurface\n \nat\n \nthe\n \nsite\n \nof\n \nthe\n \nscar.\n \nA\n \nlinear\n \nfluid\n-\nfilled\n \ntract\n \nwas\n \nalso\n \nseen\n \nwithin\n \nit.\n \n \n \n \n \nBased\n \non\n \ncharacteristic\n \nhistory\n \nand\n \nexamination\n \nfindings,\n \nthe\n \nmost\n \nprobable\n \ndiagnosis\n \nof\n \nscar\n \nendometriosis\n \nwith\n \nuterocutaneous\n \nfistula\n \nwas\n \nkept.[8]\n \n \n \nManagement:\n \nThe\n \npatient\n \nunderwent\n \nexploratory\n \nlaparotomy.\n \nIntraoperatively,\n \nan\n \ninverted\n \nY\n-\nshaped\n \nfistula\n \nwas\n \nidentified\n \nwith\n \nthe\n \nhelp\n \nof\n \na\n \nthin\n \ninfant\n \nfeeding\n \ntube\n \nconnecting\n \nabdominal\n \nskin\n \nwith\n \nthe\n \nuterus\n \nand\n \nto\n \nthe\n \ndome\n \nof\n \nthe\n \nbladder.\n \nFistulous\n \ntract\n \nexcised\n \nout\n \nan\nd\n \nthe\n \nspecimen\n \nwas\n \nsent\n \nto\n \nthe\n \npathology\n \ndepartment.\n \nLeft\n \nsalpingectomy\n \nwas\n \ndone\n \nin\n \nview\n \nof\n \nhydrosalpinx,\n \nand\n \nas\n \nbladder\n \ndome\n \nhad\n \nsome\n \nswelling\n \nattached\n \nto\n \nthe\n \nfistulous\n \ntract,\n \nsleeve\n \nresection\n \nof\n \nthe\n \nbladder\n \nwith\n \nrepair\n \nwas\n \ndone\n \nin\n \nsingle\n \ncontinuous\n \nlayer\n.\n \nUterus\n \nwas\n \nalso\n \nclosed\n \nin\n \ntwo\n \nlayers.\n \n \n \nHistopathology\n \nof\n \nthe\n \nexcised\n \ntract\n \nconfirmed\n \nendometriosis.\n \nThe\n \npatient's\n \npostoperative\n \ncourse\n \nwas\n \nuneventful\n \nand\n \nher\n \npain\n \nsubsided.\n \nThere\n \nwas\n \nno\n \nbleeding\n \nand\n \ndischarge\n \nfrom\n \nscar\n \nafterward.\n \nShe\n \nconceived\n \nspontaneously\n \nin\n \nMay\n \n2014,\n \nshe\n \nwas\n \na\n \nbooked\n \npregna\nncy\n \nin\n \nour\n \nhospital,\n \nand\n \nher\n \nantenatal\n \nperiod\n \nwas\n \nuneventful.\n \nShe\n \nunderwent\n \nemergency\n \nlower\n \nsegment\n \ncesarean\n \nsection\n \nin\n \nview\n \nof\n \nfetal\n \ndistress\n \nand\n \npreterm\n \npremature\n \nrupture\n \nof\n \nmembranes\n \nat\n \n34\n \nweeks\n \n2\n \ndays\n \nof\n \ngestation.\n \nShe\n \ndelivered\n \na\n \nhealthy\n \nmale\n \nbaby\n \nof\n \nbirth\n \nweight\n \n2.42\n \nkg.\n \nThe\n \npatient's\n \npostoperative\n \nperiod\n \nwas\n \nuneventful.\n \n \n6)\n \nCaesarean\n \nScar\n \nEndometriosis:\n \n \nScar\n \nendometriosis,\n \nalso\n \ncalled\n \nas\n \nincisional\n \nendometrioma,\n \nis\n \na\n \nrare\n \nform\n \nof\n \nextra\n \npelvic\n \nendometriosis,\n \nthat\n \noccurs\n \nin\n \nthose\n \nincisions\n \nwhere\n \nthe\n \nendometrial\n \ntissue\n \nmight\n \ncome\n \ninto\n \ncontact\n \n[2]\n.\n \nThe\n \ncesarean\n \nsection\n \nscar\n \nis\n \nthe\n \nmost\n \ncommon\n \nsite\n \nof\n \nscar\n \nendometriosis\n \n[3]\n.\n \nThe\n \nprevalence\n \nof\n \nsurgically\n \nproven\n \nendometriosis\n \nin\n \nthe\n \nscar\n \nis\n \n0.03\n \n%\n–\n1\n \n%\n \n[4]\n.\n \nAmong\n \nthose,\n \n0.03\n \n%\n–\n0.04\n \n%\n \noccurs\n \nin\n \nthe\n \npost\n-\ncesarean\n \nsection\n \nscars\n \n[2]\n.\n \nThe\n \ndiagnosis\n \nof\n \nthis\n \ncondition\n \nis\n \nconfirmed\n \nby\n \nhistopathology.\n \n \nPatients\n \ntypically\n \npresent\n \nwith\n \ncyclical\n \npain\n \nand\n \nswelling\n \nat\n \nthe\n \nsurgical\n \nscar,\n \noften\n \nyears\n \nafter\n \nthe\n \nindex\n \nsurgery.\n \nDue\n \nto\n \nlack\n \nof\n \nawareness\n \nand\n \nits\n \nresemblance\n \nto\n \nother\n \nsurgical\n \nconditions\n \nsuch\n \nas\n \nstitch\n \ngranuloma,\n \nincisional\n \nhernia,\n \nor\n \nabscess,\n \ndiagnos\nis\n \nis\n \nfrequently\n \ndelayed.\n \nThis\n \ncase\n \nseries\n \naims\n \nto\n \nhighlight\n \nthe\n \nclinical\n \nprofile,\n \ndiagnostic\n \napproach,\n \nand\n \nmanagement\n \noutcomes\n \nof\n \n16\n \npatients\n \nwith\n \ncesarean\n \nscar\n \nendometriosis.\n \n \nCase\n \nSelection\n:\n \nA\n \ntotal\n \nof\n \n16\n \npatients\n \nwere\n \nincluded\n \nin\n \nthe\n \nstudy.\n \n \n \nInclusion\n \ncriteria:\n \n•\n \nWomen\n \nwith\n \na\n \nhistory\n \nof\n \ncesarean\n \nsection\n \n•\n \nClinical\n \nsuspicion\n \nof\n \nscar\n \nendometriosis\n \n•\n \nHistopathological\n \nconfirmation\n \nfollowing\n \nexcision\n \n \nExclusion\n \nC\nriteria\n \n•\n \nEndometriosis\n \nat\n \nsites\n \nother\n \nthan\n \ncesarean\n \nscar\n \n•\n \nIncomplete\n \nmedical\n \nrecords\n \n \nTable\n \n4:\n \nS\nummary\n \nof\n \nclinical\n \npresentations\n \nof\n \npatients\n \nSymptoms\n \nNumber of patients (n=16)\n \n1.\n \nCyclical\n \npain\n \nat\n \nscar\n \nsite\n \n16 (100%)\n \n2.\n \nPalpable\n \nmass\n \n13 (81.2%)\n \n3.\n \nSkin\n \ndiscoloration\n \n3 (18.7%)\n \n4.\n \nNon\n-\ncyclical\n \npain\n \n2 (12.5%)\n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n176 \n\nInternational Journal of Science and Research (IJSR)\n \nISSN: 2319\n-\n7064\n \nImpact Factor 2025: 7.089\n \nVolume 15 Issue 8, August 2026\n \nFully Refereed | Open Access | Double Blind Peer Reviewed Journal\n \nwww.ijsr.net\n \nInvestigations\n:\n \nUltrasonography\n \nrevealed\n \na\n \nhypoechoic\n \nheterogeneous\n \nmass\n \nin\n \nthe\n \nsubcutaneous\n \nplane\n \nor\n \nrectus\n \nsheath\n \nin\n \nall\n \ncases.\n \nSize\n \nranged\n \nfrom\n \n2\n \nto\n \n5\n \ncm.\n \nMRI\n \nwas\n \nperformed\n \nin\n \nselected\n \ncases\n \nto\n \nassess\n \ndepth\n \nand\n \nmuscle\n \ninvolvement.\n \n \nManagement:\n \nAll\n \npatients\n \nunderwent\n \nwide\n \nlocal\n \nexcision\n \nwith\n \nat\n \nleast\n \n1\n \ncm\n \nhealthy\n \nmargins.\n \nFascial\n \nrepair\n \nwas\n \nrequired\n \nin\n \n7\n \ncases.\n \nNo\n \npatient\n \nrequired\n \nmesh\n \nrepair.\n \n \nHistopathological\n \nexamination\n \nconfirmed\n \nthe\n \npresence\n \nof\n \nendometrial\n \nglands\n \nand\n \nstroma\n \nwith\n \nhemosiderin\n-\nladen\n \nmacrophages\n \nin\n \nall\n \ncases.\n \n \nPatients\n \nwere\n \nfollowed\n \nup\n \nfor\n \n3\n–\n6\n \nmonths.\n \nNo\n \nrecurrence\n \nor\n \nmalignant\n \ntransformation\n \nwas\n \nobserved.\n \n \n2.\n \nDiscussion\n \n \nThis\n \ncase\n \nseries\n \nhighlights\n \nthe\n \ndiverse\n \nand\n \noften\n \nunder\n-\nrecognised\n \natypical\n \nand\n \nextra\n-\npelvic\n \nmanifestations\n \nof\n \nendometriosis,\n \nincluding\n \nscar,\n \ncutaneous,\n \nintestinal,\n \numbilical,\n \nand\n \nfistulous\n \ninvolvement.\n \nDelayed\n \ndiagnosis\n \nwas\n \ncommon\n \ndue\n \nto\n \nnonspecific\n \nsympt\noms\n \nand\n \nlow\n \nclinical\n \nsuspicion,\n \nconsistent\n \nwith\n \npreviously\n \npublished\n \nliterature.\n \n \n \nSurgical\n \nexcision\n \nwith\n \nhistopathological\n \nconfirmation\n \nremained\n \nthe\n \ncornerstone\n \nof\n \ndiagnosis\n \nand\n \ntreatment,\n \nwith\n \nfavourable\n \noutcomes\n \nand\n \nlow\n \nrecurrence\n \nrates.\n \nIncreased\n \nawareness\n \namong\n \ngynaecologists\n \nand\n \nsurgeons\n \nis\n \nessential\n \nto\n \nenable\n \nearly\n \ndiagnosis\n \nand\n \np\nrevent\n \nprolonged\n \nmorbidity\n \nin\n \naffected\n \nwomen.\n \n \n \nAcknowledgements\n \nNone\n \n \nDeclarations\n \n \nFunding:\n \nNo\n \nfunding\n \nsources.\n \n \nConflict\n \nof\n \ninterest:\n \nNone\n \nDeclared\n \n \n \nEthical\n \napproval:\n \nApproved\n \nby\n \nthe\n \nInstitutional\n \nEthics\n \nCommittee\n \n \nReferences\n \n \n[1]\n \nWorld\n \nHealth\n \nOrganization:\n \nWHO\n \n&\n \nWorld\n \nHealth\n \nOrganization:\n \nWHO.\n \n(2023,\n \nMarch\n \n24).\n \nEndometriosis\n.\n \nhttps://www.who.int/news\n-\nroom/fact\n-\nsheets/detail/endometriosis\n \n[2]\n \nTalbert\n \nLM,\n \nKauma\n \nSM.\n \nEndometriosis\n \n(1990)\n \nIn:\n \nDanforth\n \nDN,\n \nScottJR\n \n(Eds).\n \nDanforth's\n \nobstetrics\n \nand\n \ngynecology.\n \n(5thedn),\n \nPhiladelphia:\n \nJB\n \nLippincott.\n \n \n[3]\n \nDurairaj,\n \nA.,\n \nSivamani,\n \nH.,\n \n&\n \nPanneerselvam,\n \nM.\n \n(2023).\n \nSurgical\n \nScar\n \nEndometriosis:\n \nan\n \nemerging\n \nenigma.\n \nCureus\n.\n \nhttps://doi.org/10.7759/cureus.35089\n \n[4]\n \nGao,\n \nB.,\n \nLi,\n \nZ.,\n \nLiu,\n \nH.,\n \nZhou,\n \nG.,\n \n&\n \nLai,\n \nX.\n \n(2025).\n \nCo\n-\nexistence\n \nof\n \nthe\n \nabdominal\n \nwall\n \nand\n \nthoracic\n \nendometriosis:\n \ncase\n \nreport\n \nand\n \nliterature\n \nreview.\n \nFrontiers\n \nin\n \nMedicine,\n \n12.\n \nhttps://doi.org/10.3389/fmed.2025.1578\n435\n \n[5]\n \nDe\n \nCicco\n \nC,\n \nCorona\n \nR,\n \nSchonman\n \nR,\n \nMailova\n \nK,\n \nUssia\n \nA,\n \nKoninckx\n \nP.\n \nBowel\n \nresection\n \nfor\n \ndeep\n \nendometriosis:\n \na\n \nsystematic\n \nreview.\n \nBJOG.\n \n2011;118(3):285\n–\n291.\n \ndoi:\n \n10.1111/j.1471\n-\n0528.2010.02744.x\n \n[\nDOI\n]\n \n[\nPubMed\n]\n \n[\nGoogle\n \nScholar\n]\n \n[6]\n \nJuneja\n \nSK,\n \nTandon\n \nP,\n \nChopra\n \nI.\n \nSuccessful\n \npregnancy\n \nafter\n \nexcision\n \nof\n \ncesarean\n \nscar\n \nendometriosis\n \nwith\n \nuterovesicocutaneous\n \nfistula:\n \nA\n \nrare\n \ncase\n \nreport.\n \nInt\n \nJ\n \nAppl\n \nBasic\n \nMed\n \nRes.\n \n2016\n \nOct\n-\nDec;6(4):300\n-\n302.\n \ndoi:\n \n10.4103/2229\n-\n516X.192586.\n \nPMID:\n \n27857904;\n \nPMC\nID:\n \nPMC5108113.\n \n[7]\n \nSheikh\n \nMA,\n \nBegum\n \nJ,\n \nBalasubramanian\n \nG.\n \nTuboenterocutaneous\n \nfistula\n \nfollowing\n \ncaesarean\n \nsection.\n \nInt\n \nJ\n \nReprod\n \nContracept\n \nObstet\n \nGynecol\n \n[Internet].\n \n2016\n \nDec.\n \n24\n \n[cited\n \n2025\n \nDec.\n \n27];3(1):288\n-\n90.\n \nAvailable\n \nfrom:\n \nhttps://www.ijrcog.org/index.php/ijrcog/articl\ne/view/8\n53\n \n[8]\n \nDogra,\n \nP.,\n \n&\n \nSharma,\n \nR.\n \n(2017).\n \nUtero\n-\nCutaneous\n \nfistula\n \n–\n \na\n \nrare\n \ncase\n \nreport.\n \nIn\n \nSLBS\n \nGMC\n \nMandi,\n \nAnnals\n \nof\n \nInternational\n \nMedical\n \nand\n \nDental\n \nResearch\n \n(Vol.\n \n3,\n \nIssue\n \n6,\n \np.\n \n16).\n \n[9]\n \nPoudel\n \nD,\n \nAcharya\n \nK,\n \nDahal\n \nS,\n \nAdhikari\n \nA.\n \nA\n \ncase\n \nof\n \nscar\n \nendometriosis\n \nin\n \ncesarean\n \nscar:\n \nA\n \nrare\n \ncase\n \nreport.\n \nInt\n \nJ\n \nSurg\n \nCase\n \nRep.\n \n2023\n \nJan;102:107852.\n \ndoi:\n \n10.1016/j.ijscr.2022.107852.\n \nEpub\n \n2022\n \nDec\n \n28.\n \nPMID:\n \n36584626;\n \nPMCID:\n \nPMC9827051.\n \nPaper ID: SR26731165122\nDOI: https://dx.doi.org/10.21275/SR26731165122\n177","source_license":"CC0","license_restricted":false}